The traditional divide between primary care, community services, and
hospitals – largely unaltered since the birth of the NHS – is increasingly a
barrier to the personalised and coordinated health services patients need.
And just as GPs and hospitals tend to be rigidly demarcated, so too are
social care and mental health services even though people increasingly
need all three.
Over the next five years and beyond the NHS will increasingly need to
dissolve these traditional boundaries. Long term conditions are now a
central task of the NHS; caring for these needs requires a partnership with
patients over the long term rather than providing single, unconnected
‘episodes’ of care. As a result there is now quite wide consensus on the
direction we will be taking.
• Increasingly we need to manage systems – networks of care – not just
organisations.
• Out-of-hospital care needs to become a much larger part of what the
NHS does.
• Services need to be integrated around the patient. For example a
patient with cancer needs their mental health and social care
coordinated around them. Patients with mental illness need their
physical health addressed at the same time.
• We should learn much faster from the best examples, not just from
within the UK but internationally.
• And as we introduce them, we need to evaluate new care models to
establish which produce the best experience for patients and the best
value for money